How to get started with an electronic pelvic floor toner
Are you trying to get started with a Kegel8 Ultra 20 stimulation machine? Let’s be honest. The instructions that come with pelvic floor toner machines are not great. They are generally from the era of men in labs writing high-tech specs in teeny tiny writing. However, Kegel8 are a company working hard to make it easier for women to use a pelvic floor stimulation machine by themselves, or with their physiotherapist. I was delighted that they asked me to film a Q&A session with company owner Stephanie Taylor, to try to iron out some of the bits that frequently confuse.
In this video
- What’s in the box?
- Which cable goes where?
- The purpose of gel and how to insert your internal electrode
- Which buttons to press
- A good first programme to try for muscle strengthening
- Step by step what you will feel (8:47)
- Turning up with confidence!
- How many times a day when you are starting out?
Watch here (or read the adapted transcript below). In this video we are demonstrating how to get started with a stimulation machine called a Kegel8 Ultra 20 V2 Electronic Pelvic Floor Toner. Other models in the Kegel8 range are very similar. The principles are the same for all electrical stimulation machines. Even if you don’t have a Kegel8 you might find this helpful to understand how your own-brand of machine works too.
Using a stimulation machine to get a pelvic floor muscle contraction
These machines can be used for several different reasons. Today, let’s assume that you want to get a muscle contraction. First so that you can start learning exactly where your pelvic floor is. Second to know what it feels like when it is working correctly. And to help you towards the goal of learning how to do pelvic floor exercises yourself, without a machine. As recommended by physiotherapists (!). Pelvic floor exercises help problems with bladder or bowel leakage, to support a pelvic organ prolapse and for full recovery after childbirth.
What’s in the box?
In the video we can see everything that comes in the box. But we are not going to need the surface electrodes or the second wire at the moment. To get started with your stimulation machine all you need is the machine (with the battery in ) and one lead wire.
Step one – insert your vaginal probe
So the first thing I would get you to do is to put the probe in. In the video we are only going to pretend!
First put a nice big blob of gel on a tissue. Then put some gel on each bar, a really good coating. Twizzle it over and get the gel around the back. Then a bit on the end to help it go in.
When you put the probe in, I would suggest lying down. At home it could be on the sofa. So underwear off, lie flat and put the vaginal probe in with the bars going side to side. It’s not dissimilar to a tampon but you are not putting it in so far. You want to feel 1 cm of cable inside. You don’t want it sticking out on a stalk and shouldn’t be able to feel the plastic. And then you can put your underwear back on, which feels more natural. Have the cables down one knicker leg or out the top. Or your PJs or tracksuit bottoms. So that if anyone came into the room they wouldn’t know what you were doing!
Then connect your vaginal probe to the lead wire
There are two tails from the vaginal probe to connect to the lead wire. It will be a bit tight – you need to push them in until you can’t see the metal. It doesn’t matter which end to which. Some stimulation machines come with black and red coloured ends, which is a little bit disconcerting, as it does look like jump leads, but again it doesn’t matter which to which as long as a nice firm connection.
Note: When you put them in and take them out always use the tough plastic bit. Try not to pull on the wires as they are quite delicate.
Connect the lead wire to the stimulation machine
Now,the single connector at the other end will connect to the top of the hand-held machine. Plug the top of the lead wire into one of the ports on the top. It doesn’t matter which port you use. But whichever side you plug in at the top is the side buttons you should use. So all on the left or all on the right. We are going to plug into the top left. So we will be using the left hand buttons when we want to turn the machine up.
Turning on your machine
To get started with your stimulation machine press the classic “on” button symbol. Up on the screen will pop lots of information and symbols.
Choosing a first programme to try
First we are looking for which programme we are going to use. Today, for demonstrating a programme for muscle strengthening, we are going to choose Programme 10. I am going to press the programme button over and over until I have gone all the way to P10. It’s on a loop – so if you do what I did in the video and go too fast (!) you have to go all the way around again until you get back to your programme.
Now we can see the number of the programme and it’s name. Don’t get too bogged down by the names. They were pre-programmed a while ago and they don’t always exactly match with the symptoms women have. Kegel8 are making an updated list to help you choose (available soon). Programme 10 is called “stress incontinence” which you might or might not have. However, this is a muscle strengthening programme. Something many women know they need to do. P10 is a useful one to get started with a stimulation machine.
In the top Right corner you can see what we call the parameters – the frequency and the pulse width. Like when you tune your radio and choose your channel. The programme choice decides what style of electricity is going to come to you. Programme 10 has two phases, indicated by the two chevrons.
Starting with Programme 10 Phase 1
When you switch this programme on, the first phase of the programme is a sensitivity test, also for circulation. It’s not at first going to make your muscles work. The first phase is just stimulating your sensory nerves and letting you feel whether you can feel this machine. It’s really important that we know that you can feel. Because if you have damaged nerves for any reason you could feel sore before it was of benefit to you.
Look for the bottom number, Zero, in line under your connected cable. This is like the volume on your radio. It is zero which means you are getting no electricity at all. Go ahead and press the + button, + + +. I suggest you go up to 10 straight off because very few people feel much before this level. In the video, Stephanie has the probe in her hand. In her hand Stephanie it’s going to feel it very quickly and strongly because our hands are very sensitive! However, if the probe is inside the vagina you probably wouldn’t feel it at all at 10. However, the current is running – You can tell this because you can see the number go up (the mA). Each 10-15 seconds turn it up a bit more. Edging it up until you can feel it.
What to expect with the first feelings as you turn up
You will feel a light – tingly – maybe a bit scratchy sensation. Some people say it just feels warm. There isn’t a right or wrong feeling, but it’s something that wouldn’t be there otherwise. This is the first place we try to get to. Stimulating your sensory fibres and letting your brain go “Oh yes, that’s where my pelvic floor is!” Though mostly people will go “Oh, that’s not where I thought my pelvic floor was!”. Perhaps a bit deeper inside you than you were expecting? We often think it is all at the vagina opening but actually the pelvic floor muscle belly is deeper inside.
If you haven’t had much going on with your pelvic floor for a while, then this is all going to be new! This is learning. Just spending your first session FEELING and getting used to it could be all you need to do initially.
Why it might quickly change to a lighter feeling
It is normal that after after a few minutes you might notice “I can’t feel it anymore”. Why’s that? Your body is getting used to it – accommodating. Your body is going “Oh, this is alright”! Not as scary as you thought it would be! Your brain has relaxed and blanked it out a bit now. When it fades you need to turn yourself up a bit more, using the + + + until the feeling comes back again. In your first couple of sessions you will probably have to keep turning yourself up a bit, little and often. Until you have become a bit braver, got used to the feeling and know which settings work for you best.
Once you’ve got a bit more used to using this you will know where to head for straight away. But initially it’s best to go really cautiously. Don’t scare yourself, take your time, and get used to having sensations coming up to the brain from the vagina.
Moving to the second phase of programme 10
With this particularly programme we have chosen to use today, the sensory part of the programme takes 10 minutes. When this 10 minutes has gone by it will move to another phase. You will see the little numbers at the top change to 35Hz frequency and 250µs pulse width. This is the setting that could make your muscles work for you. From a muscle strengthening goal, this is where we want to get to. Past the sensory phase, onto the next phase.
Now I am going to encourage you to turn up the current (mA) of the machine more until you start to feel something actually happening inside the vagina area, where the pelvic floor muscles are.
It is a bit weird when it happens. People will say it feels “like a pressure”. Or it feels like “just like a contraction” or “like something tenses”. Or they feel something move – what they are feeling move is the probe. In the second phase the current will be coming on and off rather than be continuous like in phase 1. The contraction/electricity will be coming on for 5 seconds and then it will go to zero for 5 seconds. You will see the number at the bottom, the mA, coming on (say to your setting of 25) and then off again.
When you get started with a stimulation machine, it is really important that you have the rests. It is not wrong that it goes to zero. If you count, you will feel it coming on for 5 and off for 5. Another clue, is the little top right arrow moving to the highest position “work” and dropping down to “rest”.
Making sure you are getting a pelvic floor muscle contraction
At this point we want a pelvic floor muscle contraction. Now it’s a little bit of playing with the amplitude (the up and down buttons). You want to get it as strong as is comfortable. Because it’s only when it is a bit stronger that the muscle will actually contract. One of the problems we see with the machines used at home is that women have been plugged in, and they are running a moderate current through, but it’s not quite enough to actually make the muscle DO something. So they are not stimulating the muscle as much as they could. If you can’t get it to that place its fine. It is still of benefit to the muscle. But the best place is where you have felt it do something and then it relaxes.
Can you feel it doing something and relaxing? If you are not sure, another way to tell is to reach down and hold the cable. This is what I would do if you were in clinic to check you have the current high enough. When the machine comes on you will feel that there is a slight pulling inside. When the machine goes off you want to feel a letting go. Sometimes you are not sure if it has actually pulled in – but you feel it let go. That’s your clue!
How high to turn up the machine?!
Once you have got a muscle contraction, you can edge it up a bit higher. But never ever make this uncomfortable.
It’s wrong if you feel. thecurrent coming and you are feeling yourself backing off from it. That’s too high. That’s not helpful or therapeutic. You want the opposite. You want the feeling that when it comes you want to embrace it.
How to work with the stimulation machine
It is great to feel that you want to do your squeezes at the same time as the electricity is stimulating your muscles. If that happens, then the machine is telling some of the fibres to work and your brain is telling your fibres to work. So those are the best squeezes of all!
However, you probably wouldn’t be able to keep that up for the whole programme. So one of my tips would be to join in for a minute and then let the machine run for a minute. Then join in again and then let the machine run. Or you might count joining in for 5 of them, and then chilling out for 5 of them, letting the machine do it’s own thing. And then try to do your squeezes at the same time for 5 then relax for 5.
How long to work with the programme when you are starting out
The second phase is set to last for 15-20 minutes. If you are quite new to this, that could feel like too much initially. You might use it for 10 minutes with a sense that you’ve done way more pelvic floor squeezes in the last 10 minutes than I’ve done all year! In which case turn it off. Stop. Come back to it the next day or day after and do another short session.
You will know you are getting used to it when you don’t feel you need to turn it off. You find you are quite happy to run the whole cycle.
When you get started with a Kegel8 Ultra 20 stimulation machine there are no strict rules about what will work or not work. The most important thing is that it is comfortable and it is doing something useful for you. Perhaps something that you couldn’t do by yourself. Or that you can exercise better with it than you could do by yourself. Or you might be using it to remind yourself, every now and then, what a squeeze is supposed to feel like – so that when you are doing your 3 x a day squeezes to build your muscles up – you have a better picture in your head of what it should feel like and that you are in the right place.
What to do if it feels like too much or not enough stimulation
You might find, even part way through, that you want to take the stimulation current down a bit – almost like it is becoming a bit overwhelming. Feel free to use the – button to edge back. Or that you have got used to it and want it a bit stronger.
The stimulation current may not feel the same or be the same number of mA each time
It probably won’t be the same exact strength next time you use it. Firstly because you might put it in a slightly different place. Or you might have a bit more or a bit less gel. Or your body might just be in a different sensory place. You might not need it so high to get the same response – or you might need it a bit higher.
It is just like the volume on a radio. Find a level that you feel comfortable with but still a good contraction and sensation.
How to stop the machine at the end of the programme or sooner
When the programme is finished, the machine automatically turns itself off. Or you can just press stop (off) whenever you’ve had enough.
How to clean the probe after your stimulation session
First disconnect the 2 ends from the probe – use the plastic bits to pull not the delicate wires! Put the machine and lead wire to one side so that you won’t drop it all on the floor. Then, in your own time, take out probe inside. Wash it in warm soapy water. Or use the anti-bacterial spray that is provided to spray it and leave it to air dry. It’s what we call clean technique. The vagina isn’t a sterile place. The probe doesn’t need to be sterile but you do want your hands and the probe to be clean to avoid any infection.
Feeling more confident to get started with your stimulation machine?
I hope this post has given you more confidence to get started with a Kegel8 Ultra 20 stimulation machine or something similar? We have made several other videos about using stimulation machines. For different conditions, for example for a new mum, for a prolapse, for an overactive bladder or for stress incontinence. We also do a Q&A to show the different types of probes available. Another series is all about the pelvic floor and how to do exercises without a machine too!
Please don’t hesitate to email if you have questions and I will do my best to help. Please do comment below or on YouTube if you found these helpful.